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Neonatal adenovirus pneumonia.

W R Green¹, A W Williams

¹Department of Pathology, College of Medicine, Howard University, Washington, DC 20059.

Archives of Pathology & Laboratory Medicine

|February 1, 1989

Summary

Adenovirus infection, rare in newborns, was identified in a premature infant with hyaline membrane disease. Electron microscopy confirmed adenovirus, highlighting the need for advanced diagnostics in neonatal respiratory illness.

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Area of Science:

Neonatal Pathology
Virology
Respiratory Medicine

Background:

Premature infants with respiratory distress are susceptible to various infections.
Hyaline membrane disease (HMD) is a common respiratory complication in preterm neonates.
Viral infections can present atypically in the neonatal period.

Observation:

A 13-day-old premature infant with HMD exhibited altered pneumocytes.
Nuclear inclusions were observed in pneumocytes, with basophilic or eosinophilic staining and poor cytoplasmic preservation.
Initial testing with monoclonal antibodies for herpes simplex virus types 1 and 2 was negative.

Findings:

Electron microscopy revealed crystalline arrays characteristic of adenovirus in lung tissue.
Adenovirus infection is uncommon in neonates, contrasting with its higher prevalence in older children.
Light microscopy alone can lack specificity, potentially leading to misdiagnosis of viral infections.

Implications:

Neonatal lungs are vulnerable to a broader range of viruses beyond herpes simplex and cytomegalovirus.
Accurate diagnosis of neonatal viral pneumonia requires advanced techniques like electron microscopy.
Early and precise diagnosis is crucial for appropriate management of neonatal respiratory infections.

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